Diarrhea and Steatorrhea

Question 1

defined as an increase in daily stool weight above 200 g, increased liquidity of stools, and frequency of more than three times per day.

Answer 1

diarrhea

Question 2

Diarrhea lasting less than 4 weeks

Answer 2

acute

Question 3

diarrhea persisting for more than 4 weeks

Answer 3

chronic diarrhea

Question 4

major mechanisms of diarrhea

Answer 4

secretory
osmotic
intestinal hypermotility

Question 5

tests to differentiate fecal mechanisms

Answer 5

fecal electrolytes
fecal osmolality
stool pH

Question 6

normal total fecal osmolarity

normal fecal sodium

fecal potassium

Answer 6

(290 mOsm/kg)

30 mmol/L

75 mmol/L

Question 7

osmotic gap equation

Answer 7

Osmoticgap = 290 –[2(fecalsodium + fecalpotassium)]

Question 8

osmotic gap with greater than 50 mOsm/kg

Answer 8

osmotic diarrhea

Question 9

osmotic gap with less than 50 mOsm/kg

Answer 9

secretory diarrhea

Question 10

A fecal fluid pH of less than 5.6 indicates a malabsorption of _, causing an osmotic diarrhea.

Answer 10

sugars

Question 11

Other causes of _ are drugs, stimulant laxatives, hormones, inflammatory bowel disease (Crohn disease, ulcer- ative colitis, lymphocytic colitis, diverticulitis), endocrine disorders (hyperthyroidism, Zollinger-Ellison syndrome, VIPoma), neoplasms, and collagen vascular disease.

Answer 11

secretory diarrhea

Question 12

caused by increased secretion of water

Answer 12

secretory diarrhea

Question 13

caused by poor absorption that exerts os- motic pressure across the intestinal mucosa

Answer 13

osmotic diarrhea

Question 14

Incomplete breakdown or reabsorption of food presents _ fecal material to the large intestine, resulting in water and electrolyte _ in the large intestine

Answer 14

increased; retention

Question 15

Common Fecal Tests for Secretory Diarrhea

Answer 15

Stool cultures
Ova and parasite examinations
Rotavirus immunoassay
Fecal leukocytes

Question 16

Common Fecal Tests for Osmotic Diarrhea

Answer 16

Qualitative fecal fats
Trypsin screening
Microscopic fecal fats
Muscle fiber detection
Quantitative fecal fats
Clinitest
D-xylose tolerance test
Lactose tolerance test
Fecal electrolytes
Stool pH
Fecal osmolality

Question 17

a functional disorder in which the nerves and muscles of the bowel are extra sensitive

Answer 17

irritable bowel syndrome (IBS)

Question 18

It is the hallmark of early dumping syndrome (EDS)

Answer 18

Rapid gastric emptying (RGE) dumping syndrome

Question 19

A gastric emptying time of less than _ minutes is considered RGE.

Answer 19

35

Question 20

Normal gastric emptying is controlled by _

Answer 20

fundic tone,
duodenal feedback,
GI hormones

Question 21

EDS symptoms begin _ minutes following meal ingestion.

Late dumping occurs _ hours after a meal and is characterized by weakness, sweat- ing, and dizziness

Answer 21

10 to 30

2 to 3

Question 22

often a complication of dumping syndrome

Answer 22

hypoglycemia

Question 23

fecal fat

Answer 23

steatorrhea

Question 24

useful in diagnosing pan- creatic insufficiency and small-bowel disorders that cause mal- absorption

Answer 24

steatorrhea

Question 25

sugar that does not need to be digested but does need to be absorbed to be present in the urine

Answer 25

D-xylose

Question 26

If urine D-xylose is low, the resulting steatorrhea indicates a _

Answer 26

malabsorption condition

Question 27

A normal D-xylose test indicates _

Answer 27

pancreatitis